TRANSCRIPT OF SPEECH
Miss Caroline Moore, Solicitor
of Medical Solicitors, Sheffield
I was contacted in 1999 by a friend of Ray Nimmo‘s and I went to see Ray in Sept of 1999 and decided to take his case on against his former GPs Drs Shambhulingappa and Urgargol, a husband and wife team.
I’m sure some of you here today will already be familiar with Ray’s story but briefly, for the benefit of those who aren’t, Ray was 32 years old when he was first prescribed Benzodiazepines. At the time Ray was very happily married, with one young son and was setting up a scaffolding company with a co-director.
Ray had suffered an allergic reaction to an antibiotic called Flagyl prescribed by his GP and was experiencing stomach pains. He had some stressful life events to cope with at the time in that his father was dying from cancer.
Initially Dr Shambhulingappa gave Ray Xanax and told Ray it was a muscle-relaxant. Ray was then prescribed a series of different tranquillisers until in early 1985 he was taking 90mg of Valium which is now known as Diazepam. This marked the start of a 14 year period of repeated prescriptions of this drug.
The effects were shocking. Ray’s personality changed. He became agoraphobic and unable to cope with life. In 1986 he gave up his co-directorship. In fact the company he set up survives to date, still run by his former co-director who is now a wealthy man. Ray and his wife had planned to extend their family but Ray abandoned these plans convinced he was not fit to be a father. Ray suffered symptoms too numerous to mention.
He was told by his GPs that he was anxious and depressed. Ray thought the drug was treating his symptoms. He didn’t realise that, in fact, tolerance is soon built up to Benzodiazepines leading to involuntary addiction and the urge to take increased doses, with very distressing physical withdrawal symptoms occurring as the effects of the drug wear off in between doses.
In 1988 The Committee on Safety of Medicines issued Guidelines to all prescribing doctors in the UK advising them not to prescribe Benzodiazepines for more than four weeks and this period of time was to include tapering off the drug. The Royal College of Psychiatrists issued similar guidelines the same year and the same information was advised by Roche UK Ltd, manufacturers of Librium, Valium, Mogadon and other Benzodiazepines.
It was in 1998 when Ray met a GP, Dr Risk at Church that Dr Risk advised Ray that Diazepam was causing his problems and he should withdraw. Ray switched GPs at once and Dr Risk helped Ray withdraw, over a 3 month period.
Withdrawal symptoms from Benzodiazepines are wide-ranging and long-lasting. Ray withdrew 4 years ago and believes he has a limited degree of permanent brain damage. He still suffers some withdrawal symptoms.
Ray’s case was settled in June 2002 for a sum of £40,000 plus legal costs. This appears a low sum for more than 14 years of pain and suffering but was accepted by Ray because he had real difficulties in funding the case to trial being unable to get a legal aid certificate owing to an inheritance he received during the course of the case.
In the late 1980s/early 1990s, the manufacturers, largely of Ativan and Valium, were pursued in a group action brought by 1000s of Claimants. The group action as a fall back position also brought in prescribers being GPs and psychiatrists. The Court of Appeal stopped the group actions proceeding largely owing to the large amount of legal costs being incurred in comparison to the amount of damages that might be awarded but also owing to difficulties in individual cases in proving harm had been caused by the drugs as opposed to psychological problems some Claimants may have had before they were ever prescribed the drugs. Three of the claims against prescribers were in fact allowed to proceed. I don’t know what the outcome of these 3 cases was.
In terms of suing for damages now, I don’t think Ray’s case is the first successful claim. It’s the first reported successful claim. I have heard from other solicitor’s and barristers about other claims being conducted. One barrister was told by a London solicitor: “Oh yes I have a couple of those kind of cases. They always settle out of court”.
There are probably a few reasons why no other case has previously been reported in the press. Sometimes victims of clinical negligence don’t want publicity after receiving damages. They don’t want details of what they have been through becoming public knowledge. But I think the real problem may be numerous cases where agreement to pay compensation has been subject to a no publicity clause. Such clauses are far less popular today and we seek to avoid them where we can. However, you can see that if a Defence Union is paying out compensation for a doctor’s actions where there has previously been an attempted group action there are going to be real concerns about opening the floodgates again and encouraging other victims of negligent prescribing to come forward by allowing media attention.
Essentially, anyone who has been prescribed Benzodiazepines since 1988, who wasn’t part of the group actions may be able to bring a claim against their prescribers. Whether or not they can succeed depends on a number of factors being whether or not their prescriber has advised them as to the addictive nature of the drugs/whether they were themselves aware of this and if so, at what point in time they acquired this knowledge and whether their prescribers have in fact encouraged the patient to withdraw from the drugs or not, whether this would be by a withdrawal programme supervised by the prescriber themselves or referral by say a GP prescriber to a specialist service. Also, if a claimant has a complicated psychological history prior to prescription of Benzodiazepines that can make a claim very difficult.
In any event I think the main reason Ray wanted to publicise his case wasn’t primarily to encourage others to make claims but rather to get right to the heart of the issue which is something he has been trying to do for a via his web site and support forum. For a number of years he has been raising awareness about the dangers of benzodiazepine tranquillisers, informing and supporting fellow victims all over the world, advising doctors and medical care workers how best to help patients and campaigning for changes to be made by government. He believes the time has now come for government to stop prevaricating and initiate changes to resolve this 42-year old prescribing scandal.
I have heard today that others feel all prescribers must now be aware of the dangers of Benzodiazepines. I do not know whether this is right, or whether some precribers choose to be ignorant, or are in fact ignorant. I had one lady contact me soon after Ray Nimmo’s case was reported in the press to say that she had been taking prescribed diazepam for at least 3 years and her GP had refused her any more saying it was because of the Ray Nimmo case. He sent her away from the surgery without any alternative drug and without even putting in place a gradual withdrawal program. As many of you know this could have induced psychosis and fitting, possibly death. I advised the lady to register with a new GP urgently, which she did and I also telephoned the offending GP. I left a message I would be happy to speak to him confidentially and asked for him to return my call. He has not done so. Its quite frightening to think that other prescribers might react in this dangerous way to Ray’s case and I wish everyone campaigning for changes in the prescribing of Benzodiazepines the very best of luck.
FOOTNOTE: Following this speech a lady from CITA informed Miss Moore that she has personal knowledge of at least 40 other cases where prescribers have recently very suddenly withdrawn prescriptions of Benzodiazepines in an irresponsible manner from established involuntary addicts.